The objective of this population-based study was to
estimate the liver morbidity attributable to Schistosoma mansoni
infection by ultrasonography adopting the proposed
standard protocols of the Cairo Meeting on Ultrasonography,
1991. We examined 2384 individuals representing 20% of the
households of the rural population of the Ismailia
Governorate, East of Delta, Egypt. Prevalence of S.
mansoni and S. haematobium infections were 40.3%
and 1.7% respectively. Portal tract thickening (PTT) grade 1,
2 and 3 considered diagnostic of schistosomal liver morbidity
was detected in 35.1%, 1.3 and 0.2 individuals respectively.
Generally, ultrasonographically-detected pathological changes
increased with age, but correlated with intensity of infection
only in age group 20-59 years. Comparing individuals with and
without S. mansoni infections in an endemic and a non-
endemic community indicated no significant difference between
the former and the latter in either case.
In conclusion: ultrasonography had a limited value in
estimating schistosomal liver morbidity in our population-
based study where early grades of liver morbidly were
prevalent. The criteria of diagnosing grade I portal fibrosis
need to be revised as well as the staging system proposed by
the Cairo Meeting on ultrasonography in schistosomiasis.